The Association Between Pelvic Floor Muscle Force and General Strength and Fitness in Postpartum Women

Moss, Whitney; Shaw, Janet M.; Yang, Meng; Sheng, Xiaoming; Hitchcock, Robert W.; Niederauer, Stefan; Packer, Diane; Nygaard, Ingrid

doi:10.1097/spv.0000000000000718

Cited by 8 publications

(6 citation statements)

References 42 publications

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“…We found that strength in whole-body exercises was not correlated to PFM strength, which indicates that strength adaptions from heavy weightlifting exercises, such as back squats and deadlifts, are not specific to the PFMs. Consistent with our results, Moss et al (30) found no associations between PFM strength and different measures of strength and fitness (e.g., hand grip strength) in postpartum women. Several studies have compared PFM strength in female athletes/exercisers and nonexercisers, but the results are conflicting across studies (9).…”

Section: Discussionsupporting

confidence: 92%

Acute Effect of Heavy Weightlifting on the Pelvic Floor Muscles in Strength-Trained Women – An Experimental Crossover Study

Skaug

Engh

Bø

2023

Medicine &Amp; Science in Sports &Amp; Exercise

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Introduction/Purpose Heavy lifting may produce strain on the pelvic floor muscles (PFM) due to high increases in intraabdominal pressure, but knowledge of the impact of weightlifting on the PFM is lacking. Therefore, this study aimed to investigate acute effects of heavy weightlifting on the PFM in strength-trained women and whether general strength in whole-body exercises correlated to PFM strength. Methods Forty-seven nulliparous women between 18-35 years who regularly performed weightlifting and were able to lift their own body weight x 1.2 in back squat and 1.5 in deadlift were included in this experimental crossover study. They participated in baseline evaluations (questionnaire/measurements of background characteristics and pelvic floor disorders, 1 repetition maximum (1RM) tests in back squat and deadlift) and one test day where they were randomized to start with 60 minutes of weightlifting (4 sets of 4 repetitions at 75-85% of 1RM in back squat and deadlift) or seated rest of 60 minutes. Vaginal pressure measurements of PFM resting pressure, strength, and endurance and sEMG-measurements of PFM resting activity were performed before/after weightlifting and rest. Results No statistically significant differences were found when comparing the change in PFM resting pressure, strength, endurance, and resting activity after heavy weightlifting and rest. There were no statistically significant correlations between PFM strength and maximum (1RM) or relative strength (1RM/bodyweight) in either back squat or deadlift. Conclusions Our results imply that heavy weightlifting is well tolerated by the PFM in short-term among young, nulliparous, and strength-trained women. Strength in whole-body exercises was not correlated to PFM strength.

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Section: Discussionsupporting

confidence: 92%

Acute Effect of Heavy Weightlifting on the Pelvic Floor Muscles in Strength-Trained Women – An Experimental Crossover Study

Skaug

Engh

Bø

2023

Medicine &Amp; Science in Sports &Amp; Exercise

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“…Consistent with previous studies, we found that the number of vaginal deliveries, 14,15,26 and a family history of POP, 24,27 were independent risk factors for low PFM strength, and that MVCP decreased as the number of vaginal deliveries increased in both premenopausal parous women and postmenopausal women. Previous research has shown that taking part in physical work, which causes increased stress on the PFM, can also decrease PFM strength, 14 which is consistent with the results of the present study.…”

Section: Discussionsupporting

confidence: 91%

“…First, our study had a larger sample size and covered a wider age range compared with previous studies, in which participants tended to be younger. Additionally, ethnic differences may also be a contributing factor, given that previous literature has indicated that ethnicity can impact PFM strength 23,24 . Lastly, differences in the vaginal manometry instruments used across studies may also introduce bias into the data and contribute to differences in findings.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, ethnic differences may also be a contributing factor, given that previous literature has indicated that ethnicity can impact PFM strength. 23,24 Lastly, differences in the vaginal manometry instruments used across studies may also introduce bias into the data and contribute to differences in findings. The strength of type-I muscle fibre a 3 (…”

Section: Pfm Strength Values In Women At Different Life Stagesmentioning

confidence: 99%

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Pelvic floor muscle strength and influencing factors based on vaginal manometry among healthy women at different life stages: A multicentre cross‐sectional study

Sun,

Tian,

et al. 2024

BJOG

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ObjectiveTo assess pelvic floor muscle (PFM) strength and influencing factors among healthy women at different life stages.DesignMulticentre cross‐sectional study.SettingFourteen hospitals in China.PopulationA total of 5040 healthy women allocated to the following groups (with 1680 women per group): premenopausal nulliparous, premenopausal parous and postmenopausal.MethodsThe PFM strength was evaluated by vaginal manometry. Multivariate logistic regression was used to determine the influencing factors for low PFM strength.Main Outcome MeasuresMaximum voluntary contraction pressure (MVCP).ResultsThe median MVCP values were 36, 35 and 35 cmH2O in premenopausal nulliparous (aged 19–51 years), premenopausal parous (aged 22–61 years), and postmenopausal (aged 40–86 years) women, respectively. In the premenopausal nulliparous group, physical work (odds ratio, OR 2.05) was the risk factor for low PFM strength, which may be related to the chronic increased abdominal pressure caused by physical work. In the premenopausal parous group, the number of vaginal deliveries (OR 1.28) and diabetes (OR 2.70) were risk factors for low PFM strength, whereas sexual intercourse (<2 times per week vs. none, OR 0.55; ≥2 times per week vs. none, OR 0.56) and PFM exercise (OR 0.50) may have protective effects. In the postmenopausal group, the number of vaginal deliveries (OR 1.32) and family history of pelvic organ prolapse (POP) (OR 1.83) were risk factors for low PFM strength.ConclusionsPhysical work, vaginal delivery, diabetes and a family history of POP are all risk factors for low PFM strength, whereas PFM exercises and sexual life can have a protective effect. The importance of these factors varies at different stages of a woman's life.

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“…Similarly, there were no differences in PFM strength between 30 women with no clinical diagnosis of pelvic floor disorders who were Pilates practitioners and sedentary controls [41]. In a cross-sectional analysis of 203 primiparous women 1 year postpartum, there were no significant associations between PFM force and measures of strength and fitness, including grip strength, trunk flexor endurance duration, percent body fat, or self-reported physical activity [42]. Similarly, another cross-sectional study found no association between physical activity level, assessed by questionnaire, and vaginal resting pressure, PFM strength and endurance [43].…”

Section: Evidence Suggesting No Difference In Pfm Strengthmentioning

confidence: 90%

Is Physical Activity Good or Bad for the Female Pelvic Floor? A Narrative Review

2019

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More women participate in sports than ever before and the proportion of women athletes at the Olympic Games is nearly 50%. The pelvic floor in women may be the only area of the body where the positive effect of physical activity has been questioned. The aim of this narrative review is to present two widely held opposing hypotheses on the effect of general exercise on the pelvic floor and to discuss the evidence for each. Hypothesis 1: by strengthening the pelvic floor muscles (PFM) and decreasing the levator hiatus, exercise decreases the risk of urinary incontinence, anal incontinence and pelvic organ prolapse, but negatively affects the ease and safety of childbirth. Hypothesis 2: by overloading and stretching the PFM, exercise not only increases the risk of these disorders, but also makes labor and childbirth easier, as the PFM do not obstruct the exit of the fetus. Key findings of this review endorse aspects of both hypotheses. Exercising women generally have similar or stronger PFM strength and larger levator ani muscles than non-exercising women, but this does not seem to have a greater risk of obstructed labor or childbirth. Additionally, women that specifically train their PFM while pregnant are not more likely to have outcomes associated with obstructed labor. Mild-to-moderate physical activity, such as walking, decreases the risk of urinary incontinence but female athletes are about three times more likely to have urinary incontinence compared to controls. There is some evidence that strenuous exercise may cause and worsen pelvic organ prolapse, but data are inconsistent. Both intra-abdominal pressure associated with exercise and PFM strength vary between activities and between women; thus the threshold for optimal or negative effects on the pelvic floor almost certainly differs from person to person. Our review highlights many knowledge gaps that need to be understood to understand the full effects of strenuous and non-strenuous activities on pelvic floor health.

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The Association Between Pelvic Floor Muscle Force and General Strength and Fitness in Postpartum Women

Cited by 8 publications

References 42 publications

Acute Effect of Heavy Weightlifting on the Pelvic Floor Muscles in Strength-Trained Women – An Experimental Crossover Study

Acute Effect of Heavy Weightlifting on the Pelvic Floor Muscles in Strength-Trained Women – An Experimental Crossover Study

Pelvic floor muscle strength and influencing factors based on vaginal manometry among healthy women at different life stages: A multicentre cross‐sectional study

Is Physical Activity Good or Bad for the Female Pelvic Floor? A Narrative Review

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